Genome-wide expression analysis of vegetative organs during developmental and herbicide-induced whole plant senescence in Arabidopsis thaliana.

BACKGROUND: Whole plant senescence represents the final stage in the life cycle of annual plants, characterized by the decomposition of aging organs and transfer of nutrients to seeds, thereby ensuring the survival of next generation. However, the transcriptomic profile of vegetative organs during this death process remains to be fully elucidated, especially regarding the distinctions between natural programmed death and artificial sudden death induced by herbicide. RESULTS: Differential genes expression analysis using RNA-seq in leaves and roots of Arabidopsis thaliana revealed that natural senescence commenced in leaves at 45-52 days after planting, followed by roots initiated at 52-60 days. Additionally, both organs exhibited similarities with artificially induced senescence by glyphosate. Transcription factors Rap2.6L and WKRY75 appeared to serve as central mediators of regulatory changes during natural senescence, as indicated by co-expression networks. Furthermore, the upregulation of RRTF1, exclusively observed during natural death, suggested its role as a regulator of jasmonic acid and reactive oxygen species (ROS) responses, potentially triggering nitrogen recycling in leaves, such as the glutamate dehydrogenase (GDH) shunt. Root senescence was characterized by the activation of AMT2;1 and GLN1;3, facilitating ammonium availability for root-to-shoot translocation, likely under the regulation of PDF2.1. CONCLUSIONS: Our study offers valuable insights into the transcriptomic interplay between phytohormones and ROS during whole plant senescence. We observed distinct regulatory networks governing nitrogen utilization in leaf and root senescence processes. Furthermore, the efficient allocation of energy from vegetative organs to seeds emerges as a critical determinant of population sustainability of annual Arabidopsis.

Can an isolated middle-series item make a "Dent" in the bow-shaped serial-position curve of comparative judgments?

Studies have shown that local (e.g., midseries) items' specific properties, including being isolated from rest of the items, can generate a local distinctiveness effect, enhancing the memory performance for the local items in serial recall or absolute judgments. However, this has not been the case in relative (comparative) judgments. For the first time, the present study found a local distinctiveness effect in comparative judgments by using an opposite-gender name for the midseries item in an otherwise uniformly one-gender name serial list. The reasons for the previous studies' failure to produce this effect in comparative judgments and the present study's success in obtaining it were discussed. The implication of the finding for the item/order information opponent-process theories was also suggested.

Dealing with missing data in multi-informant studies: A comparison of approaches.

Multi-informant studies are popular in social and behavioral science. However, their data analyses are challenging because data from different informants carry both shared and unique information and are often incomplete. Using Monte Carlo Simulation, the current study compares three approaches that can be used to analyze incomplete multi-informant data when there is a distinction between reference and nonreference informants. These approaches include a two-method measurement model for planned missing data (2MM-PMD), treating nonreference informants' reports as auxiliary variables with the full-information maximum likelihood method or multiple imputation, and listwise deletion. The result suggests that 2MM-PMD, when correctly specified and data are missing at random, has the best overall performance among the examined approaches regarding point estimates, type I error rates, and statistical power. In addition, it is also more robust to data that are not missing at random.

[The Elephant in the Room: Integrative Care for Community Hospice Palliative Care in Taiwan: An Example of a Regional Teaching Hospital in Pingtung County].

Taiwan has been an aging society since 2018. As a result, long-term care, end-of-life autonomy, and hospice care have received increasing attention. The government of Taiwan promotes home-based healthcare through the National Health Insurance System to enable the efficient utilization of medical resources and reduce overall medical costs. Taiwan's community hospice and palliative care network is expected to serve as the main care model supplementing partial hospitalization and institutional care. In this article, we review the history of and policies related to hospice and palliative care in Taiwan using a literature review and examining Pingtung County as a case study. The implementation of home-based palliative care is also outlined and policy revisions are proposed. The results are intended to provide a reference for healthcare authorities and medical institutions to promote community hospice and palliative care policies. The integrated care model can enhance the capacity of community-based palliative care, support patients receiving palliative care and their family members and caregivers, and ensure physical and psychological comfort for patients. This model contributes to the realization of older adults' preference for dying at home, which is especially pronounced in cultures where traditional Chinese ideas are deeply rooted.

Testing indirect effect with a complete or incomplete dichotomous mediator.

Past methodological research on mediation analysis mainly focused on situations where all variables were complete and continuous. When issues of categorical data occur combined with missing data, more methodological considerations are involved. Specifically, appropriate decisions need to be made on estimation methods of the indirect effects and on confidence intervals for testing the indirect effects with accommodations of missing data. We compare strategies that address these issues based on a model with a dichotomous mediator, aiming to provide guidelines for researchers facing such challenges in practice.

Narratives in the medicolegal field from the perspective of physicians involved in medical dispute mediation meetings in Taiwan.

Medical treatment and narratives are interrelated. We examined this interrelation by evaluating the medical dispute mediation system in Taiwan. We conducted 16 semi-structured interviews with legal and administrative specialists in medical mediation and physicians involved in mediation meetings. The interview data were reproduced into almost verbatim text for coding and analysis. We examined how narratives were discussed in the field of medicine and identified two approaches to narratives. One was the narrative from a patient's storytelling, that is, narrative-based medicine. The other was the narrative of medical staff, which included shared decision-making and decision aids. Discussions of these approaches revolved around the avoidance of conflicts during medical treatment. However, knowing how to handle unsuccessful medical treatment is crucial. By applying polyphony in narratives, physicians can comprehend the role of narratives in unsuccessful medical treatment, helping themselves to practice how to develop narratives to communicate with patients and their surrogates when encountering any difficulty in different stages of medical treatment.

Role of PVAT in obesity-related cardiovascular disease through the buffering activity of ATF3.

Thoracic aortic perivascular adipose tissue (PVAT) is an adipose organ exhibiting similarities to brown adipose tissue (BAT), including cellular morphology and thermogenic gene expression. However, whether the PVAT phenotype is indistinguishable from the BAT phenotype in physiological vasculature remains unclear. We demonstrated that PVAT is distinguishable from classical BAT, given its specific vessel-tone-controlling function. Activating transcription factor 3 (ATF3) is a key factor in hypertension. Compared with wild-type mice, ATF3-deficient (ATF3 -/- ) mice fed a high-fat diet exhibited elevated mean arterial pressure, increased monocyte chemoattractant protein-1 expression and hypertrophy, plus abnormal fatty tissue accumulation in the thoracic aortic PVAT, and enhanced vascular wall tension and vasoconstrictive responses of potassium chloride, U46619, and norepinephrine in isolated aortic rings, which were restored after administration of adeno-associated ATF3 vector. We suggest that PVAT, not BAT, modulates obesity-related vascular dysfunction. ATF3 within PVAT could provide new insights into the pathophysiology of obesity-related cardiovascular diseases.

Developing an innovative medical ethics and law curriculum-constructing a situation-based, interdisciplinary, court-based learning course: a mixed methods study.

BACKGROUND: Traditional lecture-based medical ethics and law courses deliver knowledge but may not improve students' learning motivation. To bridge this theory-to-practice gap and facilitate students' learning effectiveness, we applied situated-learning theory to design an interdisciplinary court-based learning (CBL) component within the curriculum. Our study aimed to investigate students' learning feedbacks and propose a creative course design. METHODS: A total of 135 fourth-year medical students participated in this course. The CBL component included 1 h of introduction, 1 h of court attendance, and 2 h of interdisciplinary discussion with senior physicians, judges, and prosecutors. After the class, we conducted a survey using a mixed-methods approach to gauge students' perceptions of engagement, performance, and satisfaction. RESULTS: A total of 97 questionnaires were received (72% response rate). Over 70% of respondents were satisfied and felt that the class was useful except for role-playing activities (60%). More than 60% reported a better understanding of the practical applications of medical law. Approximately half (54%) reported less anxiety about medical disputes. 73% reported that the lecture provided awareness of potential medical disputes, and most respondents expressed an interest in medical law courses after the court visit (78%). 80% of the respondents were able to display empathy and apply mediation skills. Qualitative analyses showed that students demonstrated new knowledge, including recognizing the significance of the medical profession, distinguishing the importance of physician-patient communication, having confidence in the fairness of the justice system, and being willing to increase their legal knowledge. CONCLUSIONS: CBL curriculum increases students' learning motivation in strengthening medical professionalism and medical law, develops students' empathy for patients and communication skills, as well as builds up students' trust in the justice system. This novel course design can be applied to teach medical ethics and law.

Effect of physical exercise on popular measures of executive function in older, nonclinical, participants of randomized controlled trials: A meta-analytic review.

Epidemiological studies have found that more physically active older participants have a reduced risk of Alzheimer disease. Based on enriched environment animal models, this effect is considered to result from physical exercise-induced molecular brain changes. This hypothesis has been tested in humans with randomized controlled trials involving physical exercise vs. more sedentary interventions with neuropsychological outcome measures. Fifty-one such randomized controlled trials were identified from Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines with keywords related to physical activity, cognition, and aging supplemented with reference list search. The five most popular executive function measures (each used in ≥8 trials) were meta-analyzed. Digit symbol was the only measure with a significant estimated overall effect size, indicating that physical exercise had a small (0.17) positive effect on change scores. Estimated overall effect sizes for physical exercise on Digit Span backward, Trails B, letter fluency, and Stroop Color-Word Interference time with/without correction were all not significantly different from zero. These results provide weak support for the notion that physical exercise produces molecular brain changes that enhance executive function test scores in older, nonclinical, participants.

The selective synthesis of N-arylbenzene-1,2-diamines or 1-arylbenzimidazoles by irradiating 4-methoxy-4'-substituted-azobenzenes in different solvents.

The solvent-controllable photoreaction of 4-methoxyazobenzenes to afford 1-aryl-1H-benzimidazoles or N-arylbenzene-1,2-diamines has been studied. The irradiation of 4-methoxyazobenzenes in DMF containing 0.5 M hydrochloric acid provided N 2-aryl-4-methoxybenzene-1,2-diamines as the major product, while irradiation in acetal containing 0.16 M hydrochloric acid led to 1-aryl-6-methoxy-2-methyl-1H-benzimidazoles as the major product. A possible reaction mechanism explaining the selectivity was also discussed.

Consequences of ignoring the response-shift and measure non-invariant items in sleep studies: an empirical data based simulation of the treatment effect of CBT-I on dysfunctional sleep beliefs.

INTRODUCTION: Previous studies have shown that psychological interventions do not only improve patients' mental symptoms (i.e., true change) but may also change the internal standards patients use to evaluate their symptoms (i.e., response shifts). Although the response shifts could reflect patients' cognitive changes toward their disorders as the interventions aim to achieve, failing to differentiate them from the true change during data analyses could bias the research conclusions. Considering this issue is seldom discussed in sleep studies, this study thus examined the impacts of response-shift items in an intervention study of cognitive behavioral therapy for insomnia (CBT-I) via empirical-data based simulations. METHOD: We used longitudinal measurement invariance tests to identify the items in an abbreviated version of the Dysfunctional Beliefs and Attitudes about Sleep Scale that are non-invariant (response shifted) against CBT-I based on data from 114 insomnia patients. The partial invariance model built accordingly was then used as a population model for simulations to examine the impacts of the response-shift items on follow-up paired t-tests. RESULTS: Invariance tests indicate CBT-I would lift the intercept of one item in DBAS-10 and cause non-uniform calibrations in three items. The following up simulations showed that failing to exclude the intercept-lifted item from the calculations of the subscale scores would lower the probability of using paired t-test to correctly detect the treatment effect by up to 53%. CONCLUSIONS: We recommend sleep researchers to consider the issues of response-shift when assessing sleep-related constructs in interventional studies for insomnia.

Is All Dating Violence Equal? Gender and Severity Differences in Predictors of Perpetration.

The present study assesses the extent of perpetration of physical violence in predominately Hispanic high school students in the Rio Grande Valley, Texas. The relationship between adverse childhood experiences, exposure to interparental violence, attachment, emotion regulation, and impulsivity on two distinct, mutually exclusive, categories of severity of physical teen dating violence (TDV) perpetration is further explored. Participants completed self-report measures as part of a larger, anonymous web-based questionnaire. Two categories (i.e., minor/moderate and severe) were created to discern the contextual variables associated with different levels of severity of physical violence perpetration by males and females. Eight-hundred and twenty-nine 14- to 18-year-old adolescents from four different high schools participated in the study, of whom 407 reported having been in a dating relationship in the last 12 months. The results demonstrate that when only the most severe item of TDV is taken into consideration, the rates of violence perpetration by males and females are almost equal and remarkably lower than those reported in the literature. However, when the assessment includes minor/moderate levels of violence, such as pushing, the rates of violence perpetration by females are twice those of males and are consistent with those reported in the literature. Furthermore, different variables are associated with different levels of severity of violence perpetration. The results support approaches that emphasize the need to take the context of the violence into consideration, since all levels are not equal. The need to take the severity of violence into account in studies assessing dating violence is highlighted.

Stearic acid methyl ester affords neuroprotection and improves functional outcomes after cardiac arrest.

Cardiac arrest causes neuronal damage and functional impairments that can result in learning/memory dysfunction after ischemia. We previously identified a saturated fatty acid (stearic acid methyl ester, SAME) that was released from the superior cervical ganglion (sympathetic ganglion). The function of stearic acid methyl ester is currently unknown. Here, we show that SAME can inhibit the detrimental effects of global cerebral ischemia (i.e. cardiac arrest). Treatment with SAME in the presence of asphyxial cardiac arrest (ACA) revived learning and working memory deficits. Similarly, SAME-treated hippocampal slices after oxygen-glucose deprivation inhibited neuronal cell death. Moreover, SAME afforded neuroprotection against ACA in the CA1 region of the hippocampus, reduced ionized calcium-binding adapter molecule 1 expression and inflammatory cytokines/chemokines, with restoration in mitochondria respiration. Altogether, we describe a unique and uncharted role of saturated fatty acids in the brain that may have important implications against cerebral ischemia.

Addressing missing data in specification search in measurement invariance testing with Likert-type scale variables: A comparison of two approaches.

In measurement invariance testing, when a certain level of full invariance is not achieved, the sequential backward specification search method with the largest modification index (SBSS_LMFI) is often used to identify the source of non-invariance. SBSS_LMFI has been studied under complete data but not missing data. Focusing on Likert-type scale variables, this study examined two methods for dealing with missing data in SBSS_LMFI using Monte Carlo simulation: robust full information maximum likelihood estimator (rFIML) and mean and variance adjusted weighted least squared estimator coupled with pairwise deletion (WLSMV_PD). The result suggests that WLSMV_PD could result in not only over-rejections of invariance models but also reductions of power to identify non-invariant items. In contrast, rFIML provided good control of type I error rates, although it required a larger sample size to yield sufficient power to identify non-invariant items. Recommendations based on the result were provided.

Testing Measurement Invariance with Ordinal Missing Data: A Comparison of Estimators and Missing Data Techniques.

Ordinal missing data are common in measurement equivalence/invariance (ME/I) testing studies. However, there is a lack of guidance on the appropriate method to deal with ordinal missing data in ME/I testing. Five methods may be used to deal with ordinal missing data in ME/I testing, including the continuous full information maximum likelihood estimation method (FIML), continuous robust FIML (rFIML), FIML with probit links (pFIML), FIML with logit links (lFIML), and mean and variance adjusted weight least squared estimation method combined with pairwise deletion (WLSMV_PD). The current study evaluates the relative performance of these methods in producing valid chi-square difference tests ([Formula: see text]) and accurate parameter estimates. The result suggests that all methods except for WLSMV_PD can reasonably control the type I error rates of [Formula: see text] tests and maintain sufficient power to detect noninvariance in most conditions. Only pFIML and lFIML yield accurate factor loading estimates and standard errors across all the conditions. Recommendations are provided to researchers based on the results.

Differential blockade by huperzine A and donepezil of sympathetic nicotinic acetylcholine receptor-mediated nitrergic neurogenic dilations in porcine basilar arteries.

Nicotinic acetylcholine receptor activation on the perivascular sympathetic nerves via axo-axonal interaction mechanism causes norepinephrine release, which triggers the neurogenic nitrergic relaxation in basilar arteries to meet the need of a brain. Donepezil and huperzine A, which are the cholinesterase inhibitors used for Alzheimer's disease therapy, exert controversial effects on nicotinic acetylcholine receptors. Therefore, we investigated how donepezil and huperzine A via the axo-axonal interaction regulate the neurogenic vasodilation of isolated porcine basilar arteries and define their action on different subtypes of the nicotinic acetylcholine receptor by using blood vessel myography, calcium imaging, and electrophysiological techniques. Both nicotine (100 µM) and transmural nerve stimulation (TNS, 8 Hz) induce NO-mediated dilation in the arteries. Nicotine-induced vasodilations were concentration-dependently inhibited by huperzine A and donepezil, with the former being 30 fold less potent than the latter. Both cholinesterase inhibitors weakly and equally decreased TNS-elicited nitrergic vasodilations. Neither huperzine A nor donepezil affected isoproterenol (a ß adrenoceptor-agonist)- or sodium nitroprusside (a NO donor)-induced vasodilation. Further, huperzine A was less potent than donepezil in inhibiting nicotine-elicited calcium influxes in rodent superior cervical ganglionic neurons and inward currents in α7- and α3ß2-nicotinic acetylcholine receptor-expressing Xenopus oocytes. In conclusion, huperzine A may exert less harmful effect over donepezil on maintaining brainstem circulation and on the nicotinic acetylcholine receptor-associated cognition deficits during treatment for Alzheimer's disease.

Anidulafungin as an alternative treatment for Pneumocystis jirovecii pneumonia in patients who cannot tolerate trimethoprim/sulfamethoxazole.

Evidence supporting the use of an echinocandin alone as an alternative agent for the treatment of Pneumocystis jirovecii pneumonia (PCP) is limited and controversial. This retrospective cohort study was conducted at National Taiwan University Hospital from 1 July 2015 to 31 December 2017. Using multivariable Cox regression analyses, the outcomes of patients receiving trimethoprim/sulfamethoxazole (TMP-SMZ) or anidulafungin single therapy as an alternative treatment for PCP were investigated. A total of 207 patients with PCP were screened and 170 patients were included in the final analysis, among whom 134 (78.8%) received TMP-SMZ and 36 (21.2%) received anidulafungin as alternative anti-PCP treatment. Overall 60-day mortality was 34.1% (58/170), and 60-day mortality did not differ significantly between the anidulafungin group (38.9%; 14/36) and the TMP-SMZ group (32.8%; 44/134) (P = 0.554). Age ≥60 years [hazard ratio (HR) = 1.840, 95% confidence interval (CI) 1.039-3.259; P = 0.036] and HIV infection (HR = 0.102, 95% CI 0.013-0.771; P = 0.027) independently predicted 60-day mortality. Patients with lower SpO2/FiO2 ratio (HR = 0.994, 95% CI 0.990-0.998; P = 0.005) showed a higher 60-day mortality. In the Kaplan-Meier survival analysis, anidulafungin as alternative anti-PCP treatment was not correlated with higher mortality (P = 0.605). Using TMP-SMZ or anidulafungin as alternative anti-PCP treatment had similar 60-day mortality. These findings suggest that anidulafungin therapy may be an effective and alternative treatment for PCP in patients who cannot tolerate TMP-SMZ.

Epidemiological Characteristics of Postoperative Sepsis.

BACKGROUND: Postoperative sepsis is a major type of sepsis. Sociodemographic characteristics, incidence trends, surgical procedures, comorbidities, and organ system dysfunctions related to the disease burden of postoperative sepsis episodes are unclear. METHODS: We analyzed epidemiological characteristics of postoperative sepsis based on the ICD-9-CM codes for the years 2002 to 2013 using the Longitudinal Health Insurance Databases of Taiwan's National Health Insurance Research Database. RESULTS: We identified 5,221 patients with postoperative sepsis and 338,279 patients without postoperative sepsis. The incidence of postoperative sepsis increased annually with a crude mean of 0.06% for patients aged 45-64 and 0.34% over 65 years. Patients with postoperative sepsis indicated a high risk associated with the characteristics, male sex (OR:1.375), aged 45-64 or ≥ 65 years (OR:2.639 and 5.862), low income (OR:1.390), aged township (OR:1.269), agricultural town (OR:1.266), and remote township (OR:1.205). Splenic surgery (OR:7.723), Chronic renal disease (OR:1.733), cardiovascular dysfunction (OR:2.441), and organ system dysfunctions had the highest risk of postoperative sepsis. CONCLUSION: Risk of postoperative sepsis was highest among men, older, and low income. Patients with splenic surgery, chronic renal comorbidity, and cardiovascular system dysfunction exhibited the highest risk for postoperative sepsis. The evaluation of high-risk factors assists in reducing the disease burden.

Palmitic acid methyl ester is a novel neuroprotective agent against cardiac arrest.

We previously discovered that palmitic acid methyl ester (PAME) is a potent vasodilator first identified and released from the superior cervical ganglion and remain understudied. Thus, we investigated PAME's role in modulating cerebral blood flow (CBF) and neuroprotection after 6 min of cardiac arrest (model of global cerebral ischemia). Our results suggest that PAME can enhance CBF under normal physiological conditions, while administration of PAME (0.02 mg/kg) immediately after cardiopulmonary resuscitation can also enhance CBF in vivo. Additionally, functional learning and spatial memory assessments (via T-maze) 3 days after asphyxial cardiac arrest (ACA) suggest that PAME-treated rats have improved learning and memory recovery versus ACA alone. Furthermore, improved neuronal survival in the CA1 region of the hippocampus were observed in PAME-treated, ACA-induced rats. Altogether, our findings suggest that PAME can enhance CBF, alleviate neuronal cell death, and promote functional outcomes in the presence of ACA.

A new approach to eating-disorder classification: Using empirical methods to delineate diagnostic dimensions and inform care.

OBJECTIVE: Despite changes to the diagnostic criteria for eating disorders (EDs) in the DSM-5, the current diagnostic system for EDs has limited ability to inform treatment planning and predict outcomes. Our objective was to test the clinical utility of a novel dimensional approach to understanding the structure of ED psychopathology. METHOD: Participants (N = 243; 82.2% women) were community-recruited adults with a DSM-5 ED assessed at baseline, 6-month, and 1-year follow-up. Hierarchical factor analysis was used to identify a joint hierarchical-dimensional structure of eating, mood, and anxiety symptoms. Exploratory structural equation modeling was used to test the ability of the dimensional model to predict outcomes. RESULTS: At the top of the hierarchy, we identified a broad Internalizing factor that reflected diffuse symptoms of eating, mood, and anxiety disorders. Internalizing branched into three subfactors: distress, fear-avoidance (fears of certain stimuli and behaviors to neutralize fears, including ED behaviors designed to reduce fear of weight gain), and body dissatisfaction, which was nested within distress. The lowest level of the hierarchy was characterized by 15 factors. The hierarchical model predicted 60.1% of the variance in outcomes at 6-month follow-up, whereas all DSM eating, mood, and anxiety disorders combined predicted 35.8% of the variance in outcomes. DISCUSSION: A dimensional approach to understanding and diagnosing EDs improved the ability to prospectively predict clinical course above-and-beyond the traditional categorical (DSM-based) approach. Our findings have implications for endeavors to improve the prediction of ED prognosis and course, and to develop more effective trans-diagnostic treatments.